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BlueMedicare Saver Choice (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for BlueMedicare Saver Choice (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on BlueMedicare Saver Choice (PPO) in 2025, please refer to our full plan details page.
BlueMedicare Saver Choice (PPO) is a PPO plan offered by USAble Mutual Insurance Company available for enrollment in 2025 to people living in Select Counties in Arkansas. This plan received an overall rating of 3 out of 5 stars in 2025.
It's important to know that BlueMedicare Saver Choice (PPO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about BlueMedicare Saver Choice (PPO).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For BlueMedicare Saver Choice (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $250.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a combined Maximum Out-Of-Pocket cost of $9550.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $9550.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The BlueMedicare Saver Choice (PPO) plan has a $250 deductible for prescription drugs. After the deductible, you will pay a copay or coinsurance depending on the drug tier and pharmacy. For preferred generic drugs, you will pay a $10 copay at standard and mail order pharmacies. Standard generic drugs have a $47 copay at standard and mail order pharmacies. For preferred brand drugs, you will pay 43% coinsurance at standard and mail order pharmacies. Non-preferred drugs have 30% coinsurance at standard and mail order pharmacies.
Additional Benefits
The BlueMedicare Saver Choice (PPO) plan offers comprehensive coverage with a variety of benefits. This plan includes coverage for inpatient hospital stays, with a copay of $375 for the first 5 days, and no copay for days 6-90, as well as outpatient services with various copays. Emergency services have a $125 copay, while primary care services are covered with no copay. Additional benefits include vision, dental, and hearing services with varying copays and coinsurance. The plan also covers home health services with no copay, and skilled nursing facility services with no copay for days 1-20, and a $214 copay for days 21-100, and covers over-the-counter items with no copay, up to $80 every three months.
Inpatient Hospital See details
Inpatient Hospital services, including acute and psychiatric care, are covered by the BlueMedicare Saver Choice (PPO) plan. For the first 5 days of an inpatient stay, there is a $375 copay, and there is no copay for days 6-90. Additional days and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient Services, including outpatient hospital services and observation services, have a $325 copay, while ambulatory surgical center services have a $250 copay. Outpatient substance abuse services, including individual and group sessions, have a copay between $40 and $40. Outpatient blood services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the BlueMedicare Saver Choice (PPO) plan, but requires prior authorization. The copay for this benefit is $85.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the BlueMedicare Saver Choice (PPO) plan. Ground Ambulance Services have a $325 copay, while Air Ambulance Services have a 20% coinsurance; Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services are covered by the BlueMedicare Saver Choice (PPO) plan, with a copay of $125 for emergency services and $30 for urgently needed services, but no coinsurance. Worldwide Emergency Coverage and Worldwide Urgent Coverage have a 20% coinsurance, and Worldwide Emergency Transportation is not covered.
Primary Care See details
The BlueMedicare Saver Choice (PPO) plan covers primary care physician services with no copay, chiropractic services with a $15 copay, and occupational therapy services with a $40 copay. This plan also covers physician specialist services with a $35 copay, and mental health specialty services with a $35 copay for individual and group sessions. Additionally, the plan offers podiatry services with a $35 copay, other health care professional services with a $0-$35 copay, psychiatric services with a $35 copay for individual and group sessions, physical therapy and speech-language pathology services with a $40 copay, additional telehealth benefits with no copay, and opioid treatment program services with a $50 copay.
Preventive Services See details
The BlueMedicare Saver Choice (PPO) plan covers preventive services, including an annual physical exam with no copay. The plan also covers additional preventive services, including fitness benefits, remote access technologies, kidney disease education services, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following Welcome Visit, all with no copay. Other services such as Health Education, In-Home Safety Assessment, Personal Emergency Response System, and others are not covered.
Hearing Services See details
Hearing Services include coverage for hearing exams with a $35 copay, routine hearing exams with no copay, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids (all types) have a copay between $699 and $999, while prescription hearing aids - inner ear, outer ear, and over the ear are not covered, and OTC hearing aids are also not covered.
Vision Services See details
The BlueMedicare Saver Choice (PPO) plan covers vision services, including eye exams with a copay between $0 and $35. Eyewear is covered with a combined maximum benefit of $150 per year, and contact lenses, eyeglasses (lenses and frames), and upgrades are covered with no copay. However, eyeglass lenses and eyeglass frames are not covered.
Dental Services See details
The BlueMedicare Saver Choice (PPO) plan covers Medicare Dental Services with a $35 copay, and other dental services, up to a maximum of $3,000 per year. Oral exams and dental x-rays have no copay, and prophylaxis (cleaning) has no copay, with a limit of 2 visits per year. Restorative services, periodontics, prosthodontics (removable), and oral and maxillofacial surgery are covered with a 20% coinsurance, while fluoride treatment, adjunctive general services, endodontics, maxillofacial prosthetics, implant services, prosthodontics (fixed), and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and require prior authorization. Medicare Part B Insulin Drugs have a $35 copay, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the BlueMedicare Saver Choice (PPO) plan, with a coinsurance between 20% and 20%.
Medical Equipment See details
Medical Equipment is covered by the BlueMedicare Saver Choice (PPO) plan, including Durable Medical Equipment (DME) with 20% coinsurance, Prosthetics/Medical Supplies with 20% coinsurance, and Diabetic Equipment. Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services, lab services, and radiological services. Diagnostic Procedures/Tests have a copay ranging from $0 to $100. Lab Services have a coinsurance of at most 20%, and Diagnostic Radiological Services have a copay of at most $325, with a minimum copay of $25. Therapeutic Radiological Services have a coinsurance of at most 20%, and Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the BlueMedicare Saver Choice (PPO) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the BlueMedicare Saver Choice (PPO) plan. This includes Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the BlueMedicare Saver Choice (PPO) plan, but require prior authorization. You will have no copay for days 1-20, and a $214 copay for days 21-100. Additional days beyond Medicare-covered SNF and non-Medicare-covered SNF stays are not covered.
Other Services See details
Other Services include coverage for Over-the-Counter (OTC) Items and a Meal Benefit. There is no copay for OTC items and the plan provides up to $80 every three months. The Meal Benefit has no copay. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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